Provider Demographics
NPI:1609054030
Name:JONKER, LAURA LEE (DC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LEE
Last Name:JONKER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 E SUPERIOR ST STE 4
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55812-2045
Mailing Address - Country:US
Mailing Address - Phone:218-269-1124
Mailing Address - Fax:
Practice Address - Street 1:1730 E SUPERIOR ST STE 4
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55812-2045
Practice Address - Country:US
Practice Address - Phone:218-269-1124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-07
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5340111NP0017X
WI4346111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor